Defensive medicine behaviors among general surgeons in Southeastern Anatolia: sociodemographic and professional associations

Aims: To evaluate defensive medical behaviors among general surgeons in Southeastern Anatolia and to examine their associations with selected sociodemographic and professional characteristics. Cross-sectional analytical study. Methods: General surgeons working in Southeastern Anatolia in 2025 were invited via Turkish Medical Association channels and hospital WhatsApp groups; the survey link was sent individually and completed online with one reminder. Of 138 invited surgeons, 64 completed the survey (46.4%), with no incomplete responses. Data were collected using a 38-item survey instrument (30 Likert-type items on defensive medicine attitudes and practices 8 demographic/professional questions) refined through structured expert review and pilot-tested before field implementation from three cities. Negatively worded items were reverse-scored, a composite mean score (1-5) was calculated, and internal consistency was assessed using Cronbach’s alpha. Group comparisons were performed using appropriate parametric or non-parametric tests. Results: A total of 64 surgeons participated (46.4%). The mean composite defensive behavior score was 3.42±0.59 (range 1.61-4.32) the instrument showed excellent internal consistency (Cronbach’s α=0.912). Higher scores were observed higher among married versus unmarried surgeons (3.55±0.54 vs 3.18±0.68; p=0.039), surgeons with versus without children (3.50±0.57 vs 3.29±0.45; p=0.047), and those working outside versus in their hometown (3.53±0.46 vs 3.28±0.72; p=0.027). No significant differences were found according to years in practice, annual surgical volume, malpractice lawsuit history, or workplace type. Conclusion: Defensive medical behavior was common in this sample and was associated with selected personal and contextual characteristics. These findings should be interpreted cautiously in view of the cross-sectional design and small subgroup sizes, and they warrant confirmation in larger multicenter studies.